1Department of Urology Saitama Medical Center of Saitama Medical School, 2Department of Urology Dokkyo University School of Medicine
Azoospermia, Ejaculatory duct, Male infertility, Seminal vesicle, Ultrasonography
We used transrectal ultrasonography (TRUS) to look for obstruction of the genital duct in eight azoospermic patients with associated normal-sized testes and compared the results with those obtained with vasoseminal vesiculography (VG), testicular biopsy, or both. TRUS showed abnormal findings suggesting obstruction of the genital duct in five cases and normal findings in the other three. Subsequent VG and testicular biopsy identified three cases of obstruction of the genital duct (two cases of absence of the vas deferens
and seminal vesicle and one case of obstruction of the ejaculatory duct) from the five patients with abnormal
TRUS findings, and one case of genial-duct obstruction (obstruction of the vas deferens caused by previous
bilateral inguinal herniorrhaphy) from the three patients with normal TRUS findings. The patient with obstruction of the ejaculatory duct recieved transurethral resection of the prostatic urethra, resulting in production of semen with a high sperm count (30-50×106/ml). TRUS thus appears to be useful for detecting obstruction of the genital duct in azoospermic patients with associated normal-sized tests.